Riesgos psicosociales y calidad de vida en trabajadores de servicios oncológicos públicos / Psychosocial risks and quality of life among workers of public oncology services / Riscos psicossociais e qualidade de vida em trabalhadores de serviços públicos de oncologia

RESUMEN Introducción El trabajo desempeñado por personal de centros oncológicos genera impacto sobre ellos debido a situaciones a las que se ven expuestos, esto puede trascender en su calidad de vida. Objetivo Determinar la relación entre las variables biodemográficas, laborales, riesgos psicosociales, carga mental de trabajo y calidad de vida relacionada con salud en trabajadores de servicios oncológicos. Métodos Estudio correlacional en 113 trabajadores de servicios oncológicos de cuatro hospitales chilenos. Cuestionarios aplicados: Variables biodemográficas y laborales, Calidad de Vida Relacionada con Salud SF-36, Evaluación de riesgos psicosociales SUSESO-ISTAS 21 y Escala subjetiva de carga mental de trabajo. Resultados Variables sexo y turnos laborales presentaron correlación significativa con algún componente de la calidad de vida (p <0.05). Consulta médica (p <0.01), licencia médica (p <0.01) y problema de salud diagnosticado (p <0.05) manifestaron bajos niveles de calidad de vida. Se encontró correlación negativa tanto en los riesgos psicosociales con calidad de vida (p <0.05) como entre la carga mental de trabajo global con el componente de salud mental (p <0.01). Discusión Los trabajadores en centros oncológicos están expuestos a un mayor nivel de riesgo por las condiciones de la organización del trabajo, esto representan un riesgo a su salud. Conclusión Existe asociación entre algunas variables biodemográficas y laborales, riesgos psicosociales y carga mental con la calidad de vida relacionada con salud en trabajadores de servicios de oncología de hospitales públicos chilenos. Las organizaciones deberían implementar estrategias que permitan detectar y prevenir la exposición a riesgos psicosociales y sobrecarga mental de trabajo.

ABSTRACT Introduction The activities which workers carry out in centers of oncology can have importants impacts on their quality of life. Objective To determine the associations among biodemographical and work-related variables, psychosocial risks, work-related mental load, and health-related quality of life among workers of services of oncology. Methods This is a correlational study with 113 workers of oncology services in 4 hospitals in Chile. The questionnaires used were: Biodemographical and work-related variables, Health-Related Quality of Life SF-36, Assessment of psychosocial risks SUSESO-ISTAS 21, and the Subjective scale of mental load from work. Results The variables sex and working shifts showed a significant correlation with some components of quality of life (p <0.05), medical consultation (p <0.01), medial license (p <0.01), and diagnosed health problems (p <0.05) showed low levels in quality of life. A negative correlation was found in psychosocial risks with quality of life (p <0.05), and mental load and mental health (p <0.01). Discussion Workers in centers of oncology have a higher health risk as a result of the conditions of their jobs. Conclusion There are associations among some biodemographical and work-related variables, psychosocial risks, mental load, and health-related quality of life, in terms of health among workers in services of oncology in public hospitals of Chile. Organizations should implement strategies aimed at detecting and preventing exposure to psychosocial risks and mental overload.

RESUMO Introdução O trabalho realizado pelos funcionários do centro oncológico gera impacto neles devido às situações a que estão expostos, isso pode transcender na sua qualidade de vida. Objetivo Determinar a relação entre variáveis biodemográficas, laborais, riscos psicossociais, carga mental de trabalho e qualidade de vida relacionada à saúde em trabalhadores de serviços de oncologia. Métodos Estudo correlacional em 113 trabalhadores de serviços oncológicos de quatro hospitais chilenos. Questionários aplicados: Variáveis biodemográficas e laborais, Qualidade de Vida Relacionada à Saúde SF-36, Avaliação de riscos psicossociais SUSESO-ISTAS 21 e Escala de carga mental subjetiva. Resultados As variáveis sexo e turnos de trabalho apresentaram correlação significativa com algum componente da qualidade de vida (p <0.05). Consulta médica (p <0.01), licença médica (p <0.01) e problema de saúde diagnosticado (p <0.05) apresentaram baixos níveis de qualidade de vida. Foi encontrada correlação negativa tanto nos riscos psicossociais com a qualidade de vida (p <0.05) quanto entre a carga de trabalho mental geral e o componente de saúde mental (p <0.01). Discussão Os trabalhadores dos centros oncológicos estão expostos a um maior nível de risco devido às condições de organização do trabalho, o que representa um risco para a sua saúde. Conclusão Existe associação entre algumas variáveis biodemográficas e laborais, riscos psicossociais e carga de trabalho mental com a qualidade de vida relacionada à saúde em trabalhadores de serviços de oncologia de hospitais públicos chilenos. As organizações devem implementar estratégias para detectar e prevenir a exposição a riscos psicossociais e sobrecarga mental de trabalho.

Estudio de la expresión del receptor de vitamina D en la ontogenia del testículo y en tumores de células de leydig: posible interacción con el sistema histaminérgico

RESUMEN La vitamina D (VD), un esteroide pleiotrópico, ha sido relacionada con la función reproductiva masculina, pero aún no se ha estudiado la expresión de su receptor (RVD) en el desarrollo testicular. RVD regula la expresión de componentes del sistema histaminérgico, y la histamina (HA) modula la esteroidogénesis en células de Leydig (CL). Se ha relacionado a la deficiencia de VD con múltiples patologías, entre ellas cáncer. Los tumores de células de Leydig (TCL) son los más frecuentes del intersticio testicular, y al malignizar no responden a radio/quimioterapia. VD fue descripta como tratamiento para varios tumores, pero se desconoce su aplicación en TCL. Por lo expuesto, hemos estudiado la expresión de RVD en la ontogenia de testículo de rata, evaluando su correlación con los niveles de testosterona séricos (T) y el contenido de HA; y además evaluamos la expresión de RVD en testículo humano fetal, neonatal, prepuberal, TCL e hiperplasia de CL. En testículo de rata, se observó un aumento en la expresión de RVD en CL con la edad, en línea con el incremento de T, y en contraposición con la disminución del contenido de HA, lo cual fue consistente con la reducción en los niveles de la enzima que cataliza su síntesis, HDC. Esto sugiere que la VD podría ejercer una función en el desarrollo testicular normal, ya sea en forma directa sobre las CL o mediante la regulación de la expresión de componentes del sistema histaminérgico (HDC y/o receptores de HA). Por su parte, el TCL humano presentó sobreexpresión de RVD y HDC. Considerando que las hormonas esteroideas se encuentran aumentadas en esta patología y funcionan como factores de crecimiento, si el calcitriol pudiera modular la esteroidogénesis podría tener una aplicación terapéutica.

ABSTRACT Vitamin D (VD) is a steroid hormone traditionally related to bone health. However, several authors have associated VD with reproduction and steroidogenesis in males. The presence ofVD receptor (VDR) and the enzymes involved in its activation had been reported in several cell types of the testes. Until now, nobody has studied RVD expression during testicular development. In addition, VDR in association with its co-activators or co-repressors, regulates the expression of several genes, including those related to the histaminergic system. Previously, we demonstrated that histamine (HA) can modulate steroidogenesis in Leydig cells (LC) in a concentration-dependent manner. Also, we observed a decrease in the endogenous HA content, consistent with the previously described decrease of HDC (histidine decarboxylase, the enzyme responsible of HA synthesis) levels, during LC ontogeny. Epidemiologic studies strongly suggest that a relationship exists between VD deficiency and multiple pathologies, particularly cancer. Leydig cell tumors (LCT) are rare endocrine tumors ofunknown etiology, which originate in the testicular interstitium. The incidence worldwide is 1-3% in adults and 4% in prepubertal boys, but recent publications indicate that these figures have been increasing. While usually benign, approximately 10% of LCT in adults become malignant and do not respond to chemo or radiotherapy. It is imperative to deeply investigate the biology of LCT, to identify new therapeutic targets. The potential role of calcitriol (1a,25(OH)2-vitamin-D3) in cancer treatment has been described for several types of tumors, but it remains unexplored in LCT. Thus, as a first step, it is worth evaluating VDR expression in LCT.In view of the aforecited evidence, herein we studied VDR expression during the rat testicular ontogeny, evaluating a possible correlation withserum testosterone (T) levels in blood, endogenous levels of HA and the previously described HDC expression levels. We also analized VDR expression in human testes corresponding to three different stages of development (fetal, neonatal andjuvenile), in LCT and in LC hyperplasia. Methods: Rat testes of different ages (7, 21, 35, 90 y 240 days), human fetal, neonatal and pre pubertal testes, a human LCT and a human LC hyperplasia; were used for detection of VDR by immunohistochemistry. Results: In the rat testes, VDR expression increased with age in LC, in line with the increase in serum testosterone; and in contrast with the decrease in the endogenous content of HA and HDC levels. Likewise, we detected an increase in VDR expression with age in the human testes samples. LCT presentedVDR and HDC overexpression. We also detected VDR in LC hyperplasia. Conclusions: Given that VDR testicular expression increases with age in LC, as well as testosterone serum levels, it is reasonable to speculate thatVD may play a role in normal testicular development, either acting directly on LC or by regulating one of more components of the histaminergic system (HDC or HA receptors). Considering that VDR is overexpressed in LCT, and that steroids are increased in this pathology (and act like growth factors); if calcitriol could modulate steroidogenesis, it could have a therapeutic role.

Inhibidores de histidina decarboxilasa atenúan la actividad proangiogénica de células de Leydig tumorales: ¿Potencial terapia neoadyuvante para el tratamiento de leydigiomas? / Histidine decarboxylase inhibitors attenuate the pro angiogenic activity of Leydig tumor cells: Potential neoadjuvant therapy for the treatment of leydigiomas?

Resumen Los tumores de células de Leydig (TCL) son tumores endócrinos del intersticio testicular, cuya incidencia se encuentra en aumento. Los síntomas incluyen feminización o virilización en pacientes prepuberales, y pérdida de libido, disfunción eréctil, infertilidad y/o ginecomastia en adultos. Si bien son usualmente benignos, cuando malignizan en adultos no responden a radio y quimioterapia. Múltiples trabajos han reportado que la histidina decarboxilasa (HDC), enzima que cataliza la conversión de L-histidina en histamina (HA), tiene un rol importante en el desarrollo de tumores. A su vez, en nuestro laboratorio demostramos que la HA induce la proliferación de células de Leydig tumorales (CLT) murinas, mientras que la inhibición de HDC disminuye su proliferación y capacidad esteroidogénica. Además, observamos elevada expresión de HDC en TCL pediátricos vs. controles de distintos estadios de madurez sexual; y se ha descrito que ratones knock out para HDC poseen una angiogénesis incompleta. Para evaluar el rol de HDC en la modulación de la angiogénesis se empleó la línea de CLT de rata R2C, principal modelo utilizado en estudios de Leydigioma. También se realizaron estudios en TCL pediátricos. Los medios condicionados por las CLT R2C estimularon la angiogénesis tanto in vitro como in vivo (empleando HUVEC y analizando el grado de vascularización de membranas corioalantoideas de codorniz, respectivamente). El efecto in vitro se revirtió al tratar previamente las CLT R2C con α-metil-DL-histidinadihidrocloruro, inhibidor específico de HDC. A su vez, tanto la HA como los medios condicionados provenientes de TCL pediátricos, produjeron un aumento en la proliferación de las HUVEC. Nuestros resultados sugieren que las CLT producen HA y otros factores proangiogénicos, y que la inhibición selectiva de HDC atenúa la capacidad proangiogénica de las CLT. En base a estos resultados y evidencias previas del laboratorio, inhibidores específicos de HDC podrían ser utilizados como potencial terapia neoadyuvante en TCL.

ABSTRACT Leydig Cell tumors (LCT) are a rare group of endocrine tumors in the testicular interstitium. Between 1 and 3% of testicular malignances in adults and 4% in prepubertal children belong to LCT. An increasing incidence of this type of neoplasia has been reported recently all around the world. Particularly, a strong relationship between LCT and the use of anabolic steroids (which are commonly used nowadays) has been reported recently. In prepubertal boys, symptoms include feminization or virilization, depending on the major circulating steroid (estradiol or testosterone respectively). Adult patients show loss of libido, penile dysfunction, infertility and/or gynecomastia. Although the etiology still is unknown, several studies indicate that tumoral Leydig cells have an excessive production of insulin-like growth factor (IGF-1), as well as aromatase (CYP19) overexpression, which causes an enormous amount of estrogens (particularly estradiol, E2), and both factors play an important role in tumorigenesis. While usually benign, when LCT became malignant in adults they respond poorly to radio and chemotherapy. Likewise, it has been reported that both therapies increase the incidence of several tumors. All these data imply the need of new therapeutic targets to avoid the chirurgical dissection of the testes and the consequences of the hormonal therapies associated, which implicate not only the loss in reproductive function, but also psychological disorders. Several publications have reported that histidine decarboxylase (HDC), the only enzyme capable of catalyzing the conversion from L-histidine to histamine (HA) in mammals, has an important role in the development of several types of tumors, such as colorectal, breast and melanoma. At the same time, in our laboratory we have reported that HA induces cell proliferation of murine Leydig cells, and complementary, this cell proliferation decreases when inhibiting selectively HDC, as well as steroid synthesis (progesterone and E2). Also, we observed a higher expression of HDC in pediatric LCT (n = 3) than normal controls corresponding to different stages of sexual maturation (n = 9). It has been described that HDC knock out mice have an incomplete angiogenesis, and also that MA-10 Leydig cells HDC expression correlates with vascular endothelial growth factor (VEGF). The aim of this study is to improve our knowledge about the role of HDC in LCT biology, particularly, the angiogenesis modulation. We used the R2C Leydig cell line, the most used model for in vitro studies of Leydigioma, because it overexpresses CYP19 and constitutively produces high levels of IGF-1 and E2, as well as human LCT. R2C and pediatric LCT angiogenic capability was evaluated in vitro by measuring proliferation of human umbilical vein endothelial cells (HUVEC). In addition, we verified R2C cells angiogenic capability in vivo, using quail embryo vasculature (chorioallantoic membrane assay). Both models have been validated for the study of angiogenesis. Conditioned medium obtained from R2C cell culture stimulated angiogenesis in vitro (p <0.001) as well as in vivo (p <0.001). The in vitro effect was reverted with a previous treatment on the R2C cell culture using α-methyl-DL-histidine hydrochloride (α-MHD, 10 µM), a specific HDC activity inhibitor (p <0.001). Finally, human conditioned medium from pediatric LCT increased HUVEC proliferation (p <0.01). In the same way, the analyzed patients showed higher testosterone and estradiol levels than normal serum concentrations, which was in concordance to phenotypical features observed in presence of LCT. Our results indicate that tumoral Leydig cells (TLC) produce HA, as well as other angiogenic factors, and it could be stimulating the vascular endothelium. The selective inhibition of HDC attenuates the pro-angiogenic capability in TLC. Considering all these results and previous observations of our laboratory, specific inhibitors of HDC could be used, in the future, as a potential therapeutic target for the treatment of LCT.

Estrategia educativa dirigida a adultos mayores diabéticos tipo 2 y proveedores de salud / Educational strategy aimed at type 2 diabetic elderly and health providers

Introducción: El desarrollo educativo necesita la adopción de un enfoque multisectorial que reconozca que existen factores no educativos que impiden el aprendizaje. Objetivo: Fundamentar una estrategia educativa dirigida a adultos mayores diabéticos tipo 2 y proveedores de salud. Métodos: Estudio cuanti-cualitativo, descriptivo, entre 2011 y 2014. Parte de un diagnóstico previo del Programa de Educación al diabético en el Nivel Primario de Atención en Pinar del Río, se utilizaron métodos teóricos: análisis y síntesis, modelación y sistémico estructural y métodos empíricos: reuniones de grupo focal, grupo nominal entrevistas grupales y análisis documental. Resultados: Se determinaron las bases teóricas y se estructuró una estrategia que conto de cinco elementos o categorías para su implementación. Se identificaron 15 fortalezas, 22 debilidades, 10 oportunidades y 7 amenazas. Partiendo del objetivo, las acciones tributan al perfeccionamiento del programa de educación al diabético a Nivel Primario de Atención. Conclusiones: Se estructuró una estrategia educativa dirigida a adultos mayores diabéticos tipo 2 y proveedores de salud. El carácter participativo de la acción estratégica realizada así como el enfoque Intersectorial, forjó compromiso entre los prestadores y los pacientes diabéticos participantes favorable para la implementación de la estrategia en el nivel primario de atención(AU)

Introduction: The educational development requires the adoption of a multisectorial approach that recognizes that there are no educational factors that hold learning.Objective: To support an educational strategy aimed at educating type 2 diabetic old people and health care providers during 2011-2014 in Pinar del Rio. Methods: Quantitative, qualitative and descriptive study conducted between 2011 and 2014 from a previous diagnosis of an Educational Program for the diabetic people in Primary Health Care in Pinar del Rio, the theoretical methods used were analysis and synthesis, modeling along with structural systemic and empirical methods: focus-group meeting, nominal group interviews and analysis of documents. Results: The theoretical foundations of this strategy were determined and a strategy was structured including five items or categories for its implementation; where 15 strengths, 22 weaknesses, 10 opportunities and 7 threats were identified. Based on the objective, the actions responded to the improvement of diabetes education program for primary health care. Conclusions: An educational strategy aimed at type-2 diabetic elderly and health care providers was structured. The participatory nature of the strategic actions taken and the Intersectorial approach set the compromise between providers and diabetic patients providing a favorable participation for its implementation in the primary health care level(AU)

Inhibition of quorum sensing by compounds from two eunicea species and synthetic saturated alkylglycerols / Inhibición del quorum sensing por compuestos de dos especies de Eunicea y alquilgliceroles saturados sintéticos

Background: the emergence of bacterial resistance has led to a search for new natural products as alternatives starting points to prevent and control diseases caused by microorganisms. Among the potential candidates were bioactive compounds from octocorals of the genus Eunicea due to their chemical structures and their wide range of biological activities. Objective: the purpose of this study was to evaluate the quorum sensing inhibition (QSI) and antibacterial activity of compounds previously isolated from two Eunicea species and synthesized alkylglycerols (AKG). Methods: the QSI of three nonpolar compounds and a mixture of AKGs from Eunicea were evaluated by a microtiter plate assay using Chromobacterium violaceum (ATCC 31532). Four naturally occurring, saturated, and enantiomerically pure AKGs, all of which were derived from the chiral precursor (R)-solketal, were synthesized from alkyl chains of 12, 14, 16 and 18 carbons, and their structures were spectroscopically verified by NMR, ESI-MS and optical rotation data. Their QSI by the disc diffusion assay and minimum inhibitory concentrations (MIC) against 14 clinical bacterial isolates in microtiter plates were determined. Results: cembradiene 1, the AKG mixture and AKG (2S)-3-O-dodecyl-1,2-propanediol 4 inhibit QS at the same concentration as kojic acid (10 µg/well or 20 µg/disc, respectively). In this study, the bioactive compounds 1, stearyl oleate 2, acylglycerol 3 and AKGs 4 and (2S)-3-O-tetradecyl-1,2-propanediol 5 showed in vitro IQS activity for the first time. Additionally, 4 and 5 displayed in vitro antibacterial activity against Listeria innocua and Staphylococcus aureus (MIC = 32 µg/mL for both 4 and 5), Enterococcus faecalis (128 µg/mL and 64 µg/mL respectively), Micrococcus luteus (128 µg/mL for both) and Brevibacillus brevis (Bacillus brevis) (512 µg/mL and 64 µg/mL respectively). Conclusion: results suggest that natural compounds 1, 2, 3, 4 and 5 showed QSI, also 4 and 5 have antibacterial activity and they are an interesting alternative to continue researching their effect against pathogenic microorganisms.

Antecedentes: la aparición de resistencia bacteriana ha llevado a la búsqueda de nuevos productos naturales como puntos de partida alternativos para prevenir y controlar las enfermedades causadas por microorganismos. Entre los posibles candidatos se encontraban los compuestos bioactivos de octocorales del género Eunicea debido a sus estructuras químicas y su gama amplia de actividades biológicas. Objetivos: el propósito de este estudio fue evaluar la inhibición del quorum sensing (IQS) y la actividad antibacteriana de compuestos aislados previamente de dos especies de Eunicea y de alquilgliceroles (AQG) sintetizados. Métodos: la IQS de tres compuestos no polares y de una mezcla de AQGs de Eunicea se evaluaron mediante un ensayo de placa de microtitulación usando Chromobacterium violaceum (ATCC 31532). Cuatro AQG naturales, saturados y enantioméricamente puros, todos los cuales se derivaron del precursor quiral (R)-solketal, se sintetizaron a partir de cadenas alquílicas de 12, 14, 16 y 18 carbonos, y sus estructuras se verificaron espectroscópicamente mediante RMN, ESI-MS y datos de rotación óptica. Se determinó su IQS mediante el ensayo de difusión de disco y las concentraciones inhibitorias mínimas (CIM) en placas de microtitulación frente a 14 aislamientos bacterianos clínicos. Resultados: cembradieno 1, la mezcla de AQGs y AQG (2S)-3-O-dodecil-1,2-propanodiol 4 inhiben el QS a la misma concentración que el ácido kójico (10 µg/pocillo o 20 µg/disco, respectivamente). En este estudio, los compuestos bioactivos 1, estearil oleato 2, acilglicerol 3 y AQGs 4 y (2S)-3-O-tetradecil-1,2-propanodiol 5 mostraron actividad de IQS in vitro por primera vez. Además, 4 y 5 presentaron actividad antibacteriana in vitro contra Listeria innocua y Staphylococcus aureus (CIM = 32 µg/mL para 4 y 5), Enterococcus faecalis (128 µg/mL y 64 µg/mL respectivamente), Micrococcus luteus (128 µg/mL para ambos) y Brevibacillus brevis (Bacillus brevis) (512 µg/ mL y 64 µg/mL respectivamente). Conclusiones: los resultados sugieren que los compuestos naturales 1, 2, 3, 4 y 5 mostraron IQS, también 4 y 5 tenían actividad antibacteriana y son una alternativa interesante para continuar investigando su efecto contra microorganismos patógenos.

Profesionalismo en enfermería: una revisión de la literatura / Professionalism in nursing: A literature review / Profissionalismo na enfermagem: uma revisão da literatura

El profesionalismo en enfermería ha sido descrito como un factor que determina en mayor medida la calidad de la atención en el medio hospitalario. Objetivo: Determinar el nivel de profesionalismo de las enfermeras/os reportado por la literatura como elemento fundamental para entregar un cuidado de calidad. Método: Se realizó una revisión de la literatura científica en diferentes bases de datos internacionales, de los últimos 10 años, de acuerdo a las indicaciones del Manual Cochrane e informe PRISMA. La valoración de la calidad metodológica de los artículos se realizó mediante el instrumento Effective Public Health Practice Project (EPHPP). Resultados: Se seleccionaron 11 estudios que hacen referencia al nivel de profesionalismo de las enfermeras/os, el cual está en rangos disímiles en los diferentes países, pero se observó una concordancia en que la autonomía profesional, la publicación y la comunicación reflejaron los índices más bajos de profesionalismo. Conclusión: El nivel de profesionalismo de enfermería varía en los diferentes países. Conocer las áreas de mayor y menor déficit profesional es importante para establecer estrategias de abordaje para su mejora. El profesional de enfermería debe avanzar en el logro de elevados niveles de profesionalismo, obtener plena autonomía profesional, publicar y participar activamente en organizaciones profesionales.

Professionalism in nursing has been described as a factor which widely determines the quality of attention in the hospital environment. Objective: To determine the level of professionalism among nurses as reported by the literature. Method: A literature review was conducted on different international databases following the Cochrane Manual and the PRISMA inform, and considering only the last 10 years. The methodology quality of the articles was assessed through the Effective Public Health Practice Project instrument (EPHPP). Results: Eleven studies making reference to the level of nursing professionalism were selected. The levels of professionalism differed among the countries, but a concordance was observed regarding professional autonomy. The publishing and communication areas reflected the lowest levels of professionalism. Conclusion: The level of professionalism in nursing varies among countries; and knowing the areas with highest and lowest levels is important to develop strategies to address the issue. The nursing professionals should foster their professionalism, their autonomy, their publishing activities, and their participation in professional organizations.

O profissionalismo em enfermagem tem sido descrito como um fator que determina em maior medida a qualidade de atenção no médio hospitalar. Objetivo: Determinar o nível de profissionalismo das enfermeiras/os, reportado pela literatura como elemento fundamental para entregar um cuidado de qualidade. Método: Realizou-se uma revisão de literatura científica em diferentes bases de dados internacionais, dos últimos dez anos, de acordo às indicações do Manual Cochrane e relatório PRISMA. A valorização da qualidade metodológica dos artigos realizou-se mediante o instrumento Effective Public Health Practice Project (EPHPP). Resultados: Selecionaram-se 11 estudos que fazem referência ao nível de profissionalismo das enfermeiras/os, o qual está em faixas dissimiles nos diferentes países, mas, observou-se uma concordância em que a autonomia profissional, a publicação e comunicação refletiram os índices mais baixos de profissionalismo. Conclusão: O nível de profissionalismo de enfermagem varia nos diferentes países, conhecer as áreas de maior e menor déficit profissional, assim como estabelecer estratégias de abordagem para sua melhora. O profissional de enfermagem deve avançar na realização de elevados níveis de profissionalismo, obter plena autonomia profissional, publicar e participar ativamente em organizações profissionais.

Dermatitis atópica: A propósito de un caso / Atopic dermatitis: About a case

Se trata de una adolescente femenina de 16 años de edad, natural de Cuyagua estado Aragua y procedente de la localidad, quien presenta desde hace cuatro meses aproximadamente, prurito intenso a nivel del complejo areola pezón y exudado, amarillento, no fétido, de moderada cantidad en ambas mamas. Refiere haber consultado a facultativo quien indica tratamiento, a base de oxacilina no presentando mejoría. Acude el día 05/04/16 al Centro Integral de Especialidades "Los Grillitos", CORPOSALUD. Municipio Mario Briceño Iragorry a consulta especializada. Al examen físico se evidencia: mamas simétricas, complejo areola pezón eritematoso, con zonas de descamación, exudado amarillento y a nivel de mama izquierda se extiende hasta piel del cuadrante ínfero interno; se indica realizar paraclínicos: ecosonograma mamario, hematología completa, VSG, PCR y se toma muestra para cultivo, de la misma manera se indica tratamiento con corticoides tópicos y antibióticoterapia (ciprofloxacina). Acude a control el 15/04/16 con evolución clínica satisfactoria y resultado de cultivo positivo para S. aureus, sensible a ciprofloxacina.

It is female 16-year-old native of Cuyagua state Aragua and from the town, who presents from four months about intense itching at the level of the nipple areola complex and not fetid yellowish exudate moderate amount of both breasts, which refers consultation with physician who indicates treatment based oxacillin presented no improvement. She goes on 5/4/16 at Integral Center specialty "The Grillitos" CORPOSALUD. Municipio Mario Briceño Iragorry a specialist consultation, physical examination is evident: symmetrical breasts, nipple areola complex erythematosus, with areas of desquamation and yellowish exudate, and level of left breast extends to skin internal bottom quadrant shown performing paraclinical: sonogram breast, complete blood count, ESR, CRP and sample is taken for cultivation, in the same way treatment with topical corticosteroids and antibiotics (ciprofloxacin) is indicated. Control goes to 04/15/16 with satisfactory clinical evolution resulting in positive culture for S. aureus sensitive to ciprofloxacin.

Síndrome de Nicolau: a propósito de un caso / Nicolau Syndrome: About a case

Comunicamos una paciente femenina de 24 años de edad, natural y procedente de la localidad, quien consulta en el mes de enero de 2016 al Centro Integral de Especialidades “Los Grillitos”, CORPOSALUD. Municipio Mario Briceño Iragorry por presentar lesión ulcerosa a nivel de hemicadera derecha, cuya aparición fue posterior a la administración de medicamentos vía intramuscular (ampolla de amikacina). El tratamiento aplicado fue debido a una infección vaginal que presentó en el mes de septiembre 2015, cuyo cultivo resultó sensible a este antibiótico; comenzó a presentar un área endurecida color violáceo, hasta convertirse en una úlcera en el mes de diciembre 2015. Por este motivo, acude al médico quien indica ecosonograma de partes blandas (27/1/2016), informando: úlcera de 29 mm asociado a celulitis post infecciosa a administración medicamentosa, en hemicadera derecha y hematoma, organizado en hemicadera izquierda (0,25 cc); se realiza cultivo (27/1/2016) reportando presencia de Acinetobacter baumani complex sensible a la ciprofloxacina, la que se indica, observándose actualmente mejoría clínica de la lesión.

It is 24 years female patient age and naturally from the locality, who consults in January 2016 to Integral Center Specialty "The Grillitos" Corposalud. Municipio Mario Briceño Iragorry to present Injury ulcer type level right hemi hip whose appearance was after drug administration (vial amikacin) treatment applied due to a vaginal infection present in the month of September 2015 whose culture was sensitive to this antibiotic, he began to present purple colored hardened to become ulcerated area in December 2015. Which is why go to the doctor who said soft tissue sonography (01/27/2016) ulcer reporting 29 mm associated with post-infectious cellulitis to drug administration right hemi hip and a left organized hematoma (0.25 cc); culture (01.27.2016) is perform reporting presence of Acinetobacter baumani sensitive Ciprofloxacin treatment indicated Complex currently observed clinical improvement of the injury.

Análisis bibliometrico de los trabajos libres de neurocirugía presentados en los congresos nacionales de la sociedad Chilena de neurocirugía entre los años 2010 y 2013 / A bibliometric analysis of neurosurgical free submissionspresented in the National Congress of the Chilean neurosurgical society between the years 2010 to 2013

Introduction: Bibliometric works aim to collect and to do a quantitative analysis of the scientific production. In Chile there are no studies that characterize neurosurgical scientific production. The objective of this study is to describe the free submission presented at the last four National Congress of the Society of Neurosurgery of Chile. Materials and Methods: The abstracts books of each year National Congress of Chilean Society of Neurosurgery were reviewed between the year 2010 and 2013. Results: A total of 251 free submissions were presented, and were filiated 354 participations of 51 different institutions. The 73,1 percent of the institutions named in the different submissions came from the Metropolitan Region. The most - named hospital group was the Institute of Neurosurgery Dr. Alfonso Asenjo with a 19,2 percent(68), while the most - named University was Pontificia Universidad Católica de Chile with a 6,5 percent(23). The most common topic was tumor and vascular neuropathology with a 29,4 percent(74) and 21,1 percent(53) respectively. Discussion and Conclusions: We noticed that the majority of submissions involves one institution, with an average of 1,4 institutions per free submission, this might be explained because uncompleted filiations of authors. We can see a clear centralization of the origin of the different submissions. The two more representative areas of investigation in these congresses were tumor and vascular neuropathology. We think that is necessary to create a common protocol for registration and filiations of free submissions in the different congresses to create a National database.

Diferenças clínico-epidemiológicas entre pacientes masculinos e femininos com diagnóstico de melanoma cutâneo no oeste de Santa Catarina / Clinical-Epidemiological Differences Between Male and Female Patients Diagnosed with Cutaneous Melanoma in Western Santa Catarina

Introdução: O melanoma cutâneo representa 4% das neoplasias cutâneas, entretanto, é responsável por 80% das mortes desse grupo de neoplasias. A incidência e a prevalência dessa doença na região Oeste de Santa Catarina são maiores do que as médias nacionais. Objetivo: Identificar as diferenças clínico-epidemiológicas entre pacientes masculinos e femininos com diagnóstico de melanoma cutâneo no Oeste de Santa Catarina. Método: Foram avaliados pacientes procedentes da região Oeste de Santa Catarina, no período de janeiro/2010 a dezembro/2013. Para a coleta de dados, foi utilizado um protocolo adaptado do sistema on-line do Grupo Brasileiro de Melanoma. Resultados:Foram obtidos dados de 253 pacientes com melanoma cutâneo; dos quais, as mulheres representaram 62,45%. O tipo histológico prevalente em ambos os sexos foi o extensivo superficial. No sexo feminino, foi verificado maior número de neoplasias in situ (22,2%); e menor número de lesões cutâneas primárias com ulceração (22,8%), (p=0,02); além de menor profundidade de invasão (44,8%), (p=0,01). Conclusão: Na região Oeste do Estado de Santa Catarina, as mulheres com melanoma cutâneo apresentam características das lesões primárias que resultam em melhor prognóstico em relação ao sexo masculino.

Estudio micológico de muestras de uñas en población pediátrica y adolescente. Experiencia de un año en el Laboratorio de Dermatología, Hospital Clínico Universidad de Chile / Mycological study of nail samples in the pediatric population and adolescent

Introducción: la onicomicosis en niños y adolescentes ha presentadoaumento en la prevalencia, siendo Trichophyton rubrum detectadocon mayor frecuencia en uñas de pies y Candida en uñas de manos.Hasta la fecha no existen estudios etiológicos de onicomicosis enpoblación pediátrica chilena. Objetivo: Determinar los agentes fúngicospresentes en uñas enfermas con sospecha de onicomicosis enniños y adolescentes estudiados en el Hospital Clínico Universidadde Chile. Pacientes y método: Estudio retrospectivo que analizó losregistros micológicos de muestras de uñas de pacientes entre 0 y 18años, estudiados en el Laboratorio del Departamento de Dermatologíadel Hospital Clínico Universidad de Chile desde Enero hastaSeptiembre 2012. Todas las muestras fueron analizadas con microscopíadirecta mediante KOH 10% y cultivo de hongos en agar Sabouraud. Resultados: Se analizaron los registros de 100 pacientes, 58 de sexo masculino, con sospecha de onicomicosis. Del registro demuestras de uñas de pies (n=84), 41 presentaron micológico directopositivo para hongos filamentosos o levaduras, de los cuales 13 tuvieroncultivos de hongos positivo para T. rubrum y 2 para Candidasp. Del registro de muestras de uñas de manos (n=16), 10 tuvieronmicológico directo positivo para hongos filamentosos o levaduras, delos cuales se encontró positivo un cultivo de hongos para Candidasp...

Introduction: onychomycosis in children and adolescents haspresented increased prevalence. Trichophyton rubrum is detectedmore often in toenails and Candida sp in fingernails. Todate there are no studies of onychomycosis causative in Chileanpediatric population. Objective: To determine the fungalagents in diseased nails with suspected onychomycosis in childrenand adolescents studied at the University of Chile Clinical Hospital. Patients and method: Retrospective study analyzingmycological records of nail samples of patients between 0 and18 years old, studied at the Laboratory of the Department of Dermatology, Clinical Hospital University of Chile from Januaryto September 2012. All samples were analyzed by direct microscopywith KOH 10% and fungal culture on Sabouraud agar. Results: The records of 100 patients, 58 males, with suspectedonychomycosis were analyzed. Records toenail (n = 84),41 were positive in direct mycological test for filamentous fungior yeasts, of which 13 were positive fungal cultures for T. rubrumand 2 for Candida sp. The fingernails records (n = 16),10 were mycological direct test positive for filamentous fungior yeast, of which one fungal out culture for Candida sp waspositive...

Apoyo social formal a un grupo de madres con hijos menores de un año / Formal Social Support for a Group of Mothers with Children under Age One / Apoio social formal a um grupo de mães com filhos menores de um ano

Objetivo: este trabajo pretende analizar el apoyo social formal a un grupo de madres con hijos menores de un año. Método: estudio cualitativo, descriptivo interpretativo, en el cual participaron diez mujeres en un grupo focal que se reunió en siete ocasiones. Resultados: a partir del análisis de contenido de las dinámicas grupales se detecta que el apoyo formal informativo es el más frecuente y resulta difícil separarlo del emocional. Los profesionales, a través del apoyo informativo, tratan temas relacionados con la promoción de la salud y prevención de la enfermedad y acompañan a las madres en este rol. Conclusión: para las madres el apoyo formal brindado por el personal de enfermería es positivo y percibido como un refuerzo en su vivencia de la maternidad, y debe estar enmarcado en un contexto cultural.

Objective: Formal social support for a group of mothers with children under age one is analyzed in this research. Method: A qualitative, descriptive study of an interpretive nature was conducted in which ten women participated in a focus group that met on seven occasions. Results: A content analysis of the group's dynamics showed formal informative support is the most common and is difficult to separate from emotional support. Through informative support, professionals address issues related to health promotion and disease prevention, and accompany mothers in this capacity. Conclusion: For mothers, the formal support provided by members of the nursing staff is positive and perceived as a reinforcement of their experience with motherhood, and should be framed in a cultural context.

Objetivo: este trabalho pretende analisar o apoio social formal a um grupo de mães com filhos menores de um ano. Método: estudo qualitativo, descritivo interpretativo, do qual participaram dez mulheres em um grupo focal que se reuniu em sete ocasiões. Resultados: a partir da análise de conteúdo das dinâmicas grupais, detecta-se que o apoio formal informativo é o mais frequente e resulta difícil separá-lo do emocional. Os profissionais, por meio do apoio informativo, tratam temas relacionados com a promoção da saúde e prevenção da doença, e acompanham as mães neste papel. Conclusão: para as mães, o apoio formal oferecido pelo pessoal de enfermagem é positivo e percebido como um reforço em sua vivência da maternidade e deve estar situado em um contexto cultural.

Percepción de bienestar social y participación política en adultos de una comunidad rural en Minga Guazú, Alto Paraná / Hope and social well-being and political participation in adults belonging to a rural community of Minga Guazú, Alto Par

El objetivo principal de esta investigación es determinar la correlación entre el Bienestar Social y la Participación Política en adultos pertenecientes a una Comunidad Rural de Minga Guazú, Alto Paraná. La muestra está conformada por 70 adultos, sin discriminación de sexo. Se aplicó un diseño descriptivo y correlacional. El análisis de datos se realizó a través del Coeficiente de Correlación Lineal R de Pearson, obteniendo una relación positiva entre las dos escalas relacionadas. Se concluye que el Bienestar Social está ligado al grado de Participación Política que presenta la Comunidad Rural participante.

The main objective of this research is to determine the correlation between Social Welfare and Political Participation in adults belonging to a Rural Community from Minga Guazu, Alto Parana. The sample consisted of 70 adults, regardless of sex. We used a descriptive and correlational design. Data analysis was performed using the linear correlation coefficient R Pearson, obtaining a positive relationship between the two scales related. We conclude that Social Welfare is linked to the grades of political participation presented by the participant Rural Community.